Provider Demographics
NPI:1689392417
Name:PARKLYNN HOLDINGS LLC
Entity Type:Organization
Organization Name:PARKLYNN HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-234-5843
Mailing Address - Street 1:1 BEACH DR SE UNIT 302
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3953
Mailing Address - Country:US
Mailing Address - Phone:727-234-5843
Mailing Address - Fax:
Practice Address - Street 1:1 BEACH DR SE UNIT 302
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3953
Practice Address - Country:US
Practice Address - Phone:727-234-5843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care